March 2023

Saving Daylight

• I have posted before on daylight savings, how it is inherently unhealthy. Not only should we oppose the legislation to make permanent daylight savings, we should push for permanent standard time. That is, stop changing the clocks completely.
• This Washington Post article (not paywalled) provides the best visual explanation I have seen. Thanks Kristan for the link.
• Why daylight saving time is worse for your body than standard time.

“Healthy” Addictions

• Pretty cool brief article from Peter Attia on potential danger or harm in so-called healthy addictions. The main one he talks about is exercise, something with almost countless benefits to health: reducing risk of metabolic dysregulation, cardiovascular disease, cancer, and neurodegeneration, for emotional and mental well-being, including treatment and prevention of depression and anxiety. Exercise is also rewarding in the short term, giving us release of endorphins and cannabinoids that hit the same receptors drugs do, but without the tolerance effect, according to the Joy of Movement.
• But Attia points out that “anything that brings about acute feelings of joy and relief – whether exercise, gambling, alcohol, or heroin – has the potential to develop into addiction in certain individuals.”
• What differentiates a healthy athletic lifestyle from exercise addiction? “Withdrawal (experiencing negative physical and psychological effects such as anxiety and difficulty sleeping when exercise is ceased) and the development of tolerance (requiring an ever-increasing amount of exercise to experience the same positive sensations). Other important hallmarks include a reduction in other social, professional, or recreational activities and a lack of ability to control or limit one’s exercise level, as well as continuing to engage in exercise even after recognizing that it is “creating or exacerbating physical, psychological, and/or interpersonal problems.”
• Finally, from Attia: “In these latter cases, exercise is no longer a vehicle for promoting health but instead becomes a goal in itself – one which, in certain individuals under certain circumstances, can take priority over one’s own health and develop into addiction.”

It is called sugar alcohol

• Ok I don’t want to scare anyone, but maybe we should be a little scared. A well done new study published in the prestigious journal Nature Medicine convincingly suggests a link between erythritol (artificial sweetener that in most prior studies has looked very safe) and clotting / cardiovascular events. They looked at cardiovascular events in 1157 humans, but also at what happens in the blood stream of eight healthy human subjects right after eating the sweetener. Of note, only the subjects in the highest quartile of blood levels of the substance appeared to have CV risk. 
• Even though you don’t want to “change practice” based on one study, this is very concerning. This article is dense and worth reading, but the TL;DR is that we should be looking at other sweeteners until more data comes out on erythritol. The tough thing will be giving up Quest bars and other desserts; they are always high protein and very low carb. You will also find erythritol in energy drinks and keto ice cream products. 
• For an alternative, check out allulose; you can buy it in granular form. Some packaged foods also use allulose, eg. Magic Spoon cereal. Stevia still appears quite safe. No evidence yet against xylitol (dangerous for dogs) or monk fruit. 
• Here is a post reviewing the paper. Here is a quote: “Do I believe after reading this paper that erythritol should be banned from food and you’ll get a stroke if indulge a keto snack? Of course not. Will I generally avoid erythritol even with my (so far) CVD risk? Yeah, probably.”

Can you read people’s character?

• Check out this post from Ted Gioia on the tools he uses to decide if someone has moral character. You can also take a look at yourself with these points in mind. 1. Forget what they say—instead look at who they marry.
2. See how they treat service workers
3. Discover what experiences formed their character in early life
4. How do they invest their two most valuable resources? (time and money)
5. Identify what irritates people the most in others—because this is probably the trait they dislike most in themselves.
6. Can they listen?
7. If they cheat at small things, they will cheat at big things
8. Watch how they handle unexpected problems

Bars

• Ok as covered in the post above, erythritol may have some health risks and more studies are needed. One of my favorite bars right now are Built Bars, but make sure to get the Puffs variety. They are similar to Charleston Chews. The regular Built bar takes forever to chew. The Puffs version also has gelatin, that healthy collagen type protein. I have seen them in store at GNC, but Amazon has the variety packs of 12. Another option with a few more carbs, less protein, and no gelatin: Laird Superfood Bars


Adverse Childhood Experiences

• Parenting is tough. Kids need adversity and challenges to grow, to get the drive to fight for what they believe in. But just like most things in life, you want the right amount – not too much or too little.
• The Adverse Childhood Experiences (ACE) score has extensive data behind it now to predict later life outcomes. We follow it closely in our academic research on substance use. This is a nice summary from Delanceyplace.com of the important parts of ACE research, from the book The Body Keeps the Score. Similar books include the recent and impressive The Myth of Trauma by Gabor Maté (and Matés amazing book on addiction called The Realm of Hungry Ghosts). Surprised I haven’t included Gabor Maté in prior newsletters, will do so in near future. 
• For a counterpoint, see The End of Trauma by Bonanno, which talks about the concept creep of trauma. How if everything is traumatic, then eventually nothing is. What is normal? The ACE score relates to what most if not all people would consider truly traumatic events and ideally no children would have to go through such trauma. 
• Thanks Dan for reminding me about delanceyplace. 

Quotes

We must learn to regard people less in the light of what they do or omit to do, and more in the light of what they suffer.
— Dietrich Bonhoeffer

The first question is not why the addiction; it’s why the pain? …
And from my perspective, it’s always rooted in childhood trauma, either overt or covert.
— Gabor Mate

Martin Huecker, MD, is co-editor in chief of the free, open access Journal of Wellness. He is an Associate Professor and Research Director in the Department of Emergency Medicine (EM) at the University of Louisville. He is a member of Phi Beta Kappa, and the Alpha Omega Alpha medical honor society. Dr. Huecker graduated from UofL’s EM Residency Program and (Chief Resident in 2011). He works full time seeing patients and teaching residents in the UofL Emergency Department. His diverse research interests include substance use, accidental hypothermia, and healthcare professional wellness. Dr. Huecker is also a Certified Lifestyle Medicine Physician (DipABLM). He loves books, (cold) trail runs, dogs, and coffee. His wife is an OB/GYN and they have 4 children with cool names.